With advances in drug development, the increasing prevalence of diabetes, and the growing demand for innovative therapies, the field of diabetes medications continues to evolve. Diabetes affects millions of people globally, and major pharmaceutical companies are launching treatment options that not only improve blood sugar control but also address cardiovascular and kidney-related complications, offering comprehensive diabetes disease management for patients.
Here, we introduce the top 10 diabetes medications based on 2024 sales trends, exploring the factors behind their success.
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Indications: Type 2 Diabetes, Cardiovascular Risk
Ozempic structure
Why it's a bestseller: Ozempic's popularity has surged, solidifying its position as the world's top-selling diabetes medication, and it is set to become the top-selling drug globally. Its sales grew by 66% year-on-year. The demand for glucagon-like peptide-1 (GLP-1) receptor agonists continues to rise, driven by widespread attention, and while Ozempic is approved for treating type 2 diabetes, its significant weight loss side effect has made it a trendy weight loss solution.
Since 2022, Novo Nordisk has faced challenges with drug shortages due to high demand and supply chain limitations. The company is still addressing supply issues related to semaglutide-based products, including the weight loss drug Wegovy.
Indications: Type 2 Diabetes, Chronic Heart Failure, Chronic Kidney Disease
Empagliflozin structure
Why it's a bestseller: In 2023, Jardiance accounted for 28.8% of Boehringer Ingelheim's net sales, becoming the best-performing product. Its sales grew by 26.6% compared to 2022. Eli Lilly's sales of Jardiance reached $2.745 billion last year, ranking fifth in the company's total sales, growing by 33%. According to Boehringer Ingelheim's 2023 annual report, the drug's strong performance was attributed to the continued growth of indications, including approval for chronic kidney disease and treatment for pediatric type 2 diabetes in Europe and the U.S. Eli Lilly also attributed the strong sales growth to increased domestic demand, global sales expansion, and favorable exchange rates in markets outside the U.S.
Top 3: Trulicity (Dulaglutide)
Indications: Type 2 Diabetes
Schematic diagram of Trulicity's mechanism of action
Why it's a bestseller: Trulicity is a GLP-1 receptor agonist that enhances glucose-dependent insulin secretion, playing a key role in controlling blood sugar levels in adults with type 2 diabetes. Over 95% of diabetic patients have type 2 diabetes. Trulicity's total sales in 2023 reached $7.132 billion, and its established efficacy in reducing cardiovascular risk and the availability of higher doses continue to drive its strong market share.
Eli Lilly's total sales in Q4 of 2023 grew by 28%, reaching $9.35 billion, thanks to strong performances from both new products and existing medications. The company's target is to achieve revenue of $40.4 billion to $41.6 billion in 2024 to sustain growth.
Indications: Type 1 Diabetes, Type 2 Diabetes
Insulin structure
Why it's a bestseller: Insulin is a crucial treatment for the survival of type 1 diabetes patients and is essential for controlling blood sugar in many type 2 diabetes patients, making it a cornerstone of diabetes care. The global insulin market is expected to grow from $19.69 billion in 2024 to $25.08 billion by 2032, driven primarily by the increasing prevalence of diabetes, sedentary lifestyles, and advances in insulin products.
Key players in the global insulin market include Eli Lilly, Novo Nordisk, Sanofi, along with emerging competitors like Biocon and Boehringer Ingelheim. These companies are focusing on expanding new markets, improving affordability, and developing next-generation diabetes management solutions.
Indications: Type 2 Diabetes, Type 1 Diabetes, Heart Failure
Dapagliflozin structure
Why it's a bestseller: Farxiga is a novel sodium-glucose cotransporter-2 (SGLT2) inhibitor taken once daily. With increasing research emphasizing the interconnection of heart, kidney, and pancreas functions, research on this drug continues to expand, investigating its potential in prevention and organ protection. Farxiga's sales saw a significant increase after it was approved for heart failure and kidney disease. Over the past decade, it has proven effective both as a monotherapy and in combination with other treatments, improving blood sugar control in adults with type 2 diabetes when used alongside diet and exercise.
Indications: Type 2 Diabetes, Obesity
Mounjaro structure
Why it's a bestseller: Tirzepatide is the first dual-action glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 receptor agonist, approved for the treatment of type 2 diabetes. It targets GIP receptors to complement the action of GLP-1, improving insulin regulation and blood sugar control. In November 2023, the FDA also approved tirzepatide (Zepbound) for chronic weight management in obese adults.
Indications: Diabetes
NovoRapid structure
Why it's a bestseller: NovoRapid is a fast-acting insulin produced using modern DNA recombinant technology. It can be used alone or combined with other intermediate-acting or long-acting insulins to control blood sugar in both adults and children with diabetes.
Its structure and action resemble that of naturally released human insulin, even acting faster, making it highly effective in controlling blood sugar. When injected, NovoRapid starts working within 10 to 20 minutes, may reach peak concentration in 40 to 50 minutes, and lasts for about 3-5 hours.
NovoRapid was launched in Europe in 1999 and is now sold in over 120 countries worldwide.
Indications: Type 2 Diabetes
Rybelsus structure
Why it's a bestseller: Rybelsus experienced significant growth in sales in 2022, with sales in Danish Krone (DKK) soaring by 134% to 11.299 billion DKK (approximately $1.6 billion). This strong momentum continued into 2023, with sales in DKK growing by 66%, reaching 18.75 billion DKK (approximately $2.7 billion).
Indications: Type 2 Diabetes
Sitegliptin structure
Why it's a bestseller: In 2023, Januvia's sales reached $2.189 billion. The FDA approval was based on the results of two double-blind, placebo-controlled monotherapy studies and two double-blind, placebo-controlled combination therapy studies. Compared to placebo, a daily dose of 100 mg of Januvia significantly improved HbA1c, fasting plasma glucose (FPG), and postprandial 2-hour glucose (PPG).
Indications: Type 2 Diabetes
Linagliptin structure
Why it's a bestseller: Since Boehringer Ingelheim acquired full rights to Trajenta from Eli Lilly in 2019, the drug's sales have remained stable. Trajenta's efficacy has been confirmed in clinical trials, showing significant reductions in HbA1c both as monotherapy and as an add-on therapy. In a randomized, parallel-group Phase III study comparing Trajenta with placebo, Trajenta therapy reduced HbA1c by -0.69% (p < 0.0001) at 24 weeks, and patients treated with linagliptin were more likely to achieve a HbA1c reduction of ≥0.5% at 24 weeks compared to placebo.
